Management Of Traumatic Dental Injuries Research Articles

Interpretation of the International Association of Dental Traumatology guidelines for the management of traumatic dental injuries (2020)

An update version of the International Association of Dental Traumatology (IADT) guidelines for the management of traumatic dental injuries has been released in June 2020 (http://www.dentaltraumaguide.org). In this current revision, IADT has put forward a "core outcome set" (COS) for the diagnosis and treatment of dental trauma both in children and adults. The COS was developed and underpinned by a systematic review of the outcomes in the literature of dental trauma treatment. An outcome that was relevant to all traumatic dental injuries (TDI) was identified as "generic outcome" and those related only to one or more particular TDI were then included as "injury-specific outcomes". The aims of the present article are to help the dental clinicians in learning the latest version of the guideline so that they may quickly and accurately grasp the essence of the updated content and to assist them to choose the optimized treatment plan after judging and evaluating the specific clinical circumstances so as to maximize the chance of a favorable outcome.

School Teachers' Knowledge and Attitudes about the Emergency Management of Traumatic Dental Injuries in Turkey.

The emergency management of traumatized teeth is critical to their long-term outcomes. In school-aged children, most traumatic dental injuries (TDI) occur at school and teachers are often required to manage dental trauma (DT) emergencies. Therefore, the aim of this study was to determine teachers' knowledge and attitudes about TDI. Survey in 147 randomly selected schools in 53 cities in Turkey. A questionnaire enquiring about demographic data, knowledge of DT, and knowledge of first aid related to DT was distributed to primary school teachers. 1,634 completed questionnaires were returned (65% response rate). 92.5% of the teachers were not satisfied with their DT knowledge, and almost all (97.8%) had never received DT training, although 28.1% had witnessed at least one case of DT. In the case of tooth avulsion, 26.4% believed that an avulsed tooth would be permanently lost, whereas 28.9% knew that a permanent tooth could be replanted. Knowledge of emergency management of TDI among schoolteachers in Turkey is inadequate, and training on their emergency management should be provided.

Evaluation of Knowledge- Attitude- Practice (KAP) of Intern Dentists in Emergency Management of Traumatic Dental Injuries in Primary Anterior teeth: A Cross-sectional Study

Evaluation of Knowledge- Attitude- Practice (KAP) of Intern Dentists in Emergency Management of Traumatic Dental Injuries in Primary Anterior teeth: A Cross-sectional Study

Evaluation of Knowledge- Attitude- Practice (KAP) of Intern Dentists in Emergency Management of Traumatic Dental Injuries in Primary Anterior teeth: A Cross-sectional Study

Evaluation of Knowledge- Attitude- Practice (KAP) of Intern Dentists in Emergency Management of Traumatic Dental Injuries in Primary Anterior teeth: A Cross-sectional Study

Primary Care Dentists' management of permanent dentition traumatic dental injuries in 7- to 16-year-olds: A sequential mixed-methods study.

Primary care dentists play a pivotal role in the management of traumatic dental injuries in children, despite little evidence on the barriers they face in providing care. The aim of this study was to explore and contextualize the knowledge and attitudes of general dental practitioners regarding their management of permanent dentition traumatic dental injuries in children aged 7-16years old. A two-phase sequential mixed-methods study included a questionnaire that was disseminated to all 619 primary care dentists, identified via a triangulated sampling strategy, based across the north-east of England (Phase I). Statistical analyses were performed using Mann-Whitney U- and Kruskal-Wallis tests, Spearman's correlation and chi-square test. Multivariate factor analysis, with principal components extraction, was used to test between multiple ordinal variables. Respondents were invited to a face-to-face or telephone semi-structured interview (Phase II). Interviews were transcribed verbatim and analysed using inductive thematic analysis. Primary care dentists were less confident in managing complex dental trauma. Inadequate financial remuneration was the main reason for not providing care, often prompting a referral to the local dental hospital. This was more apparent for those who qualified before 2000. More recently qualified dentists felt the long-term costs, related to traumatic dental injuries, were insufficiently remunerated. Most still provided emergency management, irrespective of remuneration, as long as they had the requisite knowledge and skills. Four major themes arose: impact of traumatic dental injuries on patients, parents and primary care dentists; barriers to providing treatment; educational opportunities for primary care dentists; and interactions between primary and secondary care services. There is high confidence in managing simple traumatic dental injuries but less for complex injuries. A lack of sufficient financial remuneration associated with the long-term management of dental trauma was the main barrier for dentists to manage these cases.

What is new in the 2020 International Association of Dental Traumatology emergency treatment guidelines?

Over the past eight years, there have been marked changes in the recommendations for the management of traumatic dental injuries (TDIs). The recently published International Association of Dental Traumatology (IADT) guidelines for the emergency management of TDIs provide a comprehensive manual for clinicians to refer when assessing and managing patients presenting with these types of injuries. Clinicians should be prepared to utilize these new guidelines which were released in 2020. The aim of this short communication is to support those with previous knowledge regarding the IADT guidelines, to identify the changes in treatment modality, and to provide backing for those exposed to trauma guidelines for the first time. In the present communication, the areas of TDIs have been separated into primary and permanent teeth plus avulsions, with a tabular format highlighting the main changes in the emergency management from the previous version in 2012. This format has been devised to aid the clinicians' understanding of the variations over time and facilitate recall of the new guidelines. For the first time, the 2020 IADT Guidelines present a Core Outcomes Set (COS) that includes outcomes that were relevant to all TDIs and outcomes related to only one or several TDIs. However, the COS is not the object of the present publication.

Diagnosis and Management of Traumatic Dental Injuries Using Intraoral Radiography and Cone-beam Computed Tomography: An In Vivo Investigation

The aim of this study was to compare periapical radiographs (PRs) and upper standard occlusal (USO) radiographs with cone-beam computed tomographic (CBCT) imaging on clinicians' confidence in the diagnosis and management of traumatic dental injuries (TDIs). This study included 35 maxillary anterior teeth from 25 patients with at least 1 PR (parallax view) and a CBCT scan. Fourteen patients also had a USO radiograph. Ten examiners selected a diagnosis and treatment plan, which were compared with a reference standard. Sensitivity, specificity, positive and negative predictor values, and receiver operating characteristic analysis were used to determine the diagnostic accuracy. CBCT imaging exhibited significantly higher sensitivity than both conventional radiographic techniques combined (PRs and PRs + USO radiographs) for all diagnoses (TDI: 99% vs 84%, lateral luxation: 80% vs 34%, extrusions: 92% vs 42%, and cortical plate fracture: 58% vs 1%) other than horizontal root fractures in which the results were close to statistical significance (88% vs 69%). CBCT imaging was significantly more accurate for all diagnoses (TDI: 91% vs 70%, lateral luxations: 83% vs 61%, extrusive luxations: 92% vs 68%, alveolar cortical plate fractures: 78% vs 48%, and horizontal root fractures: 93% vs 82%).Examiners had the most confidence with CBCT imaging and the least confidence in diagnosing using PRs + USO radiographs than with PRs alone. Agreement with management plans was significantly better using CBCT imaging compared with PRs and PRs + USO radiographs. CBCT imaging improved the clinical diagnosis of TDIs. The addition of USO radiographs to PRs did not improve the diagnosis of TDIs in this investigation. CBCT imaging improved confidence in the diagnosis of TDI cases and treatment planning compared with conventional radiography.

Dentists’ Knowledge about Management of Traumatic Dental Injuries in Turkey: A Cross-Sectional Study

Objective: The aim of the present study was to evaluate the knowledge level of general dental practitioners (GDPs) and dental specialists (DSs) about the management of TDIs. Materials and methods: A total of 199 participants from three cities in Turkey completed the online questionnaires. The first section of the questionnaire consisted of questions regarding personal information, while the second section consisted of 12 multiple-choice questions regarding the knowledge of managing different types of TDIs in children. The data were statistically analyzed using the chi-square test and t-test. Results: The questionnaires were completed by 145 GDPs and 54 DSs. In total, 29.1% of the participants (58) had less than 3 years of experience, 20.6% (41) had between 3 and 6 years of experience, 16.1% (32) had between 7 and 10 years of experience, 14.1% (28) had between 11 and 15 years of experience, 8% (16) had between 16 and 20 years of experience, and 12.1% (24) had more than 20 years of experience in clinical practice. Dentists with lesser years of experience (<10 years) were more knowledgeable than those with more years of experience (p=0.001). Moreover, DSs were more knowledgeable than GDPs (p=0.002). Conclusion: Our findings revealed a moderate level of knowledge about TDI management among dental practitioners. These findings highlight the need to improve dentists’ knowledge about TDI treatment protocols.

A Rehabilitation of Missing Maxillary Anterior Teeth in a Severe Skeletal Class III Malocclusion Patient Requiring Implants

Management of traumatic dental injuries (TDI) in a young patient may range from simple to complex. In a situation where teeth are lost, a reliable and conservative treatment option is an implant-supported fixed dental prosthesis (i-FDP), as this treatment option negates the need to prepare sound abutment teeth as in the case of conventional fixed bridges. However, the placement of implants is usually prosthetically driven to allow for a 3D functional and aesthetic restoration. In the presence of severe skeletal Class III malocclusion, treatment may incorporate pre-surgical orthodontic treatment, followed by jaw surgery to correct the skeletal discrepancies and finally post-surgical orthodontic treatment before the rehabilitation with implants. A multidisciplinary treatment approach in a stepwise manner is required to address the patient’s overall treatment needs. This case report presents a joint prosthodontics, orthodontics and oral maxillofacial surgical management of a young adult male patient with a Skeletal Class III malocclusion who required rehabilitation of avulsed missing anterior teeth sustained from childhood TDI. The severity of the skeletal relationship required a Le Fort I maxillary advancement and a bilateral sagittal split osteotomy for the setback of the mandible in combination with orthodontics for correction of malocclusion and arch relationship prior to implant placement. Correction of the malocclusion and jaw deformity allowed the functional and aesthetic rehabilitation of the missing teeth using an i-FDP.

School teachers' knowledge and experience about emergency management of traumatic dental injuries: A questionnaire-based online cross-sectional survey.

Dental trauma is one of the critical oral health problems in childhood and adolescence that can affect an individual's quality of life. Teachers may witness a dental injury on many occasions, and they are likely to be involved at the site of an accident. Hence, they should be capable of managing prompt and correct emergency treatment at the accident site. The aim of this cross-sectional study was to assess the level of knowledge and experience of Croatian elementary and high school teachers concerning dental trauma. A questionnaire-based cross-sectional online survey was conducted to determine knowledge and experience about traumatic dental injuries among 803 full-time working elementary and high school teachers. The inclusion criteria were full-time employment at the time of data collection with at least 1year of teaching experience. Retirement (teachers aged ≥65years) and unwillingness to participate in the survey were the exclusion criteria. The Student t test or one-way ANOVA, with Tukey's post hoc was used to evaluate the obtained data. The level of significance was set at p≤.05. The overall mean level of teachers' knowledge regarding emergency management of dental trauma was 6.6±2.5 points, out of a maximum possible score of 14. There were no significant differences in knowledge among teachers from lower elementary, upper elementary, and high school education (6.9±2.5, 6.5±2.4 vs 6.4±2.6 points, respectively; p=.140). Teachers who had personally experienced dental trauma showed better knowledge (7.2±2.6 vs 6.4±2.5 points; p≤.001). The knowledge of emergency management of dental trauma among elementary and high school teachers in Croatia is low. Since most of the participants expressed willingness for future education regarding this subject, educational programs are recommended.

Effect of Two Educational Interventions Regarding the Management of Traumatic Dental Injuries on Mothers of 8-Year-Old Children.

Objectives:This study evaluated the effect of two educational interventions on knowledge and self-reported practice of mothers of 8-year-old children regarding emergency management of traumatic dental injuries (TDIs).Materials and Methods:Six public elementary schools (girls and boys) in Tehran were randomly selected. The mothers of 8-year-old students at each school were randomly assigned to three groups: intervention by poster, intervention by pamphlet, and control. An anonymous valid and reliable questionnaire, including demographics, previous experience on TDIs, mothers’ knowledge, and self-reported practice about emergency management of TDIs was provided to the mothers. After collecting the questionnaires, educational interventions by poster and pamphlet with similar contents regarding step-by-step emergency management of TDIs were performed for the target groups. Three months after the interventions, the same questionnaire was completed by the mothers. The results of pre-test and post-test were compared.Results:Totally, 201 mothers participated in this study. The mean knowledge score significantly increased in the pamphlet group (P<0.05) after the intervention, while this change was not significant in the poster and control groups (P>0.05). The mean knowledge score was significantly higher in the pamphlet than the poster group (P=0.009). The mean self-reported practice score significantly increased after the intervention in both intervention groups (P<0.05) but not in the control group. There was no significant difference in the mean self-reported practice score between the two intervention groups (P>0.05).Conclusion:Both pamphlet and poster were equally effective in improving the self-reported practice of mothers regarding TDIs, which highlights the significance of educating mothers.

Evaluation of knowledge- Attitude- Practice (KAP) of Intern Dentists in Emergency Management of Traumatic dental Injuries in Permanent Anterior teeth (A Cross-sectional Study)

Background: This cross-sectional study aimed to evaluate the Egyptian intern dentist’s knowledge, Attitude, and Practice in the emergency management of traumatic dental injuries in primary anterior teeth. Materials and methods: A four-part questionnaire was distributed among a total of 500 intern dentists. Part 1 consisted of 8 questions focusing on personal and professional information, part 2 consisted of 7 questions focused on 3 clinical cases, Part 3 consisted of 9 close-ended questions to assess the attitude of intern dentists, and part 4 consisted of 4 close-ended questions related to the assessment of the practice of intern dentists regarding traumatic dental injuries in primary anterior teeth in children. The data were analyzed using the t-test at P < 0.05 level of confidence. Results: A total of 500 intern dentists participated in the survey, 235 were males and 265 were females. The overall mean age was 23.6 ± 1.3 years. The mean value of knowledge scores was 4.37 ± 1.45. There was no statistically significant correlation between the knowledge score of the intern dentist and the ability to provide proper action when needed. Conclusion: The knowledge of intern dentists regarding the management of traumatic dental injuries in primary anterior teeth was inadequate.

Knowledge, attitude, and practice of Chennai school teachers on traumatic dental injuries management - A cross-sectional study.

Aim:To assess the knowledge, attitude, and practice of traumatic dental injury (TDI) management among school teachers of Chennai.Materials and Methods:Forty-seven schools were selected from various parts of Chennai for the cross-sectional survey by simple random sampling. Four hundred school teachers who participated were from 26 regular schools and 21 special schools. Questionnaire with 32 close-ended questions assessing knowledge, attitude, and practice of TDI management was devised, face validated by experts, and pilot tested. Link to the online survey questions was provided after obtaining the informed consent. Responses were analyzed using Microsoft Excel.Results:Twenty-two percent reported to have undergone first aid training and among them, 4% were trained on TDIs management. 27% had a false sense of knowledge and practice of TDIs management. 12% were confident in replanting an avulsed tooth by themselves. Ten percent were aware of using milk as a storage media. 86% were willing to learn about TDIs management.Conclusions:Within the limitations of the present study, it can be concluded that despite the lack of knowledge and practice regarding TDI management, school teachers of Chennai had a good attitude towards TDI education. Emergency management training is by itself a necessity in schools and it should be inclusive of TDI management.

Assessment of knowledge of traumatic tooth fracture management among endodontists and general practitioners in two different countries: A cross-sectional survey

Introduction: Knowledgeable and timely management of traumatic dental injuries (TDIs) plays a decisive role in their long-term prognosis. The aim of this study was to assess knowledge of managing traumatic tooth fracture of permanent teeth among endodontists and general practitioners (GPs) set in two different countries. Materials and Methods: A two-part self-administered questionnaire assessing knowledge of traumatic tooth fracture management was distributed among 400 professionals in Saudi Arabia and the United Kingdom. The first part contained seven questions related to the participants' demographic data, and the second part included ten questions related to the management of trauma case scenarios focused on crown and root fracture. Data were statistically analyzed. Results: One hundred and eighty-two individuals participated in this survey. Endodontists managed TDIs more frequently, and the mean number of their correct answers was significantly higher when compared with GPs (P = 0.004). Specialty was the constant predictor of level of knowledge (P = 0.001) excluding geographic location and frequency of treating TDIs. Conclusion: The level of knowledge of the participants in both countries in managing traumatic tooth fracture was moderate. Correct answer score was influenced by having a specialty in endodontics. Dental professionals' perception of their knowledge did not reflect their objectively measured level.

Global status of knowledge for prevention and emergency management of traumatic dental injuries in sports persons and coaches: A systematic review.

Sports-related dental injuries can cause pain, disfigurement, and broken teeth which may affect the athlete's well-being and psychological status. Such injuries may also lead to the fear of re-injury and other problems. Since a delay in adequate emergency treatment can have adverse effects, it is imperative that athletes and coaches have sufficient awareness of emergency treatment options. Hence, the aim of this systematic review was to evaluate the global status of knowledge among athletes and coaches regarding the prevention and emergency management of traumatic dental injuries. The protocol was designed using the PRISMA guidelines and registered in PROSPERO (CRD42020184956). A broad-based search using text words and MeSH terms was performed in established databases according to a predefined strategy without any distinction of language and year of publication. Studies without details of the questionnaire, knowledge score, validity, and reliability were excluded. Data extraction was performed and risk-of-bias assessment was done by means of the Joanna Briggs Institute's critical appraisal tool. Nine studies published between 2005 and 2020 were included for qualitative synthesis. They were primarily from Asia with none from North America and Australia. Most of them were cross-sectional, used convenience sampling, and were interview-based. Less than 10% of the participants in two studies had adequate knowledge of the immediate emergency management of tooth avulsion, while only 2.4% of basketball players and coaches knew that it was necessary to collect the avulsed tooth or broken tooth fragments. The overall level of knowledge was reported as poor or insufficient in all studies, with moderate or high risk-of-bias in six studies. The knowledge regarding emergency management of TDI was found to be low globally. Along with the choice of the sport, there was a high level of variability in the study design and sampling characteristics.

Global status of knowledge for prevention and emergency management of traumatic dental injuries in dental professionals: Systematic review and meta‐analysis

Dental professionals are the primary care providers for traumatic dental injuries (TDI). The dental traumatology literature has a number of studies evaluating the knowledge of dental professionals from different parts of the world but its global status is unknown. Hence, the aim of this systematic review was to assess the global status of knowledge for the prevention and emergency management of TDI in dental professionals and to provide recommendations for future research. The protocol was designed as per the PRISMA guidelines and registered in PROSPERO (CRD42020192381). A broad-based search using text words and MeSH terms was performed in established databases as per a pre-defined strategy without any distinction of language and year of publication. Studies without details of the questionnaire, knowledge score, validity and reliability were excluded. Data extraction was performed, risk of bias assessment was done using the Joanna Briggs Institute's critical appraisal tool, and a meta-analysis was performed. Sixteen studies, which had been published between 2008 and 2020, were included for qualitative synthesis. Most of them were cross-sectional, used convenience sampling and evaluated knowledge for avulsion. Previous dental trauma training was undertaken by <50% of the participants of five studies, <50% knew about the correct approach in management of complicated crown fractures in three studies and ≤60% in four studies knew the critical time for replantation. There was insufficient level of knowledge in >50% of the included studies. High risk of bias was found in three studies. The knowledge level in several areas of the world was unknown. The studies lacked uniformity in methods and well-designed questionnaires and they revealed insufficient levels of knowledge among dental professionals.

Evaluating the knowledge level, attitudes, and therapeutic approaches of Greek dentists for traumatic dental injuries.

Greek dentists are facing a new era of a globally continuous effort to improve the first-aid management and long-term treatment outcome of traumatic dental injuries (TDI). In Greece, where the basic and clinical research in the field of dental trauma has been limited until recently, assessing the attitudes and therapeutic strategies of Greek dentists for dental trauma is of great importance. The aim of this study was to evaluate the knowledge attitudes and therapeutic approaches of Greek dentists in different clinical scenarios of TDI. A cross-sectional study was conducted among 448 dentists. A questionnaire-based survey of demographic characteristics, attitudes, and a scenario-based knowledge test, of TDI, which was used to formulate a "Dental Trauma Knowledge Score" with a 0-8 score range, was administered. Mann-Whitney U tests (for two categories variables) and Kruskal-Wallis tests (for more than two categories variables) were performed. The median knowledge score was 5.0 (IQR: 4-7), a level considered as "Acceptable." Knowledge scores were found to significantly differ by age group, with the younger dentists presenting the highest scores. Dentists with a self-evaluation as "Acceptable" had significantly higher scores. Most of the dentists would refer for CBCT in severe trauma cases. A significant association was found between younger ages and on awareness of the mobile application ToothSOS. Female dentists had significantly higher scores compared to males when asked about avulsion management. An acceptable level of knowledge on TDI management was revealed among dentists in Greece. Higher knowledge scores were observed among younger dentists.

Parental Knowledge and Attitude About the Emergency Management of Traumatic Dental Injuries and the Predictive Factors Affecting their Knowledge - A Cross Sectional Study in Makkah, Saudi Arabia

Background:Traumatic dental injuries (TDIs) are common dental problems among children worldwide. Some of these injuries occur at home, where parents are considered responsible for reporting them and taking the first action, which directly can influence the prognosis. The present study aims to quantify the level of parents’ knowledge and attitude towards emergency management of TDI and to predict the factors that affect their level of knowledge. Subject and Methods: 269 questionnaires were completed by parents who live in Makkah, Saudi Arabia. The questionnaire was divided into three parts, including questions on demographic data, knowledge, and attitude about emergency management, and self-assessed knowledge and attitude toward further education on TDI emergency management. Results: The average knowledge score was 2 out of 9 (SD±1.9). More than 78% of the participants were enthusiastic about further free education and believed that they don’t have enough knowledge about TDI. A significant positive association has been predicted, using a multivariable Poisson model, between the parental knowledge score and their willingness to attend free lessons, having a previous idea about TDI, higher educational background, confidence, and higher socioeconomic class (SEC). However, the history of a previous TDI was predicted to have a significant negative influence on the knowledge score (p values &lt;0.05). Conclusion: Parents of children in Makkah city show a weak level of knowledge about TDI emergency management. A concerning attitude was shown as parents tend to proceed to manage TDIs against the recommended managements rather than seeking professional advice. A specific dental educational program targeting parents is essential.

The International Association of Dental Traumatology ToothSOS mobile app: A 2-year report.

The shift in health care and technology calls for innovation through mobile applications as free educational resources for the masses. The International Association of Dental Traumatology (IADT) created ToothSOS, an app (software application for mobile devices) to provide dental trauma information for patients and professionals. The app contains information on the emergency management and prevention of dental injuries, as well as treatment guidelines for dental practitioners. The aim of this study was to assess public utilization of the ToothSOS app in the first 2years since its launch. The ToothSOS app was launched by the IADT in the first week of April 2018. Data regarding the number of downloads and usage of the app in the first 2years (from April 2018 to May 2020) were collected and analyzed. The total number of ToothSOS downloads over the 2years was 47725. The number of downloads peaked in the first month when the app was initially released. Thereafter, the number of downloads decreased to an average of 1423±363 downloads every month. Europe was the territory with the greatest number of downloads followed by the United States and Canada, Asia, Latin America and the Caribbean, and Africa, the Middle East, and India. Within as short a period as 2years, the ToothSOS app continues to gain public interest. Further attempts and public campaigns should be made in order to increase the visibility of the app. Dental professionals should encourage patients and communities to use the app in order to increase awareness for the prevention and proper emergency management of traumatic dental injuries.

Traumatic dental injuries in the Eastern Region of Saudi Arabia: Factors influencing teachers' management practices.

Traumatic dental injuries (TDIs) in children frequently occur in schools where teachers can play an important role in their management. Therefore, the aim of this study was to assess schoolteachers' knowledge and the factors that determine their management of TDIs. This cross-sectional study was conducted in the Eastern Province of Saudi Arabia from January to June 2018. Data were collected through an online pre-tested questionnaire. The questionnaire collected demographic data and included questions that assessed participants' knowledge and management practices for TDI. Chi-square test and multivariate logistic regression analysis were performed. A total of 443 teachers were included in the study, and 72.5% of the participants were females. The prevalence of TDIs was 49% yet only 7.2% of the participants reported managing dental trauma. Fights (22.8%) and falls (21.7%) were the most common causes of dental injuries. Mean TDI knowledge score was 2.75±2.05, but only 47.2% were willing to receive training about TDI management. Regarding supportive environments, 75.8% of teachers reported having safety playgrounds, however 10.6% reported having a nurse in schools. After controlling for other variables, male respondents were 3.85 times more likely to manage TDIs than female respondents (P=.001). Similarly, previous knowledge of dental trauma management (OR=4.32, P<.001) and having less than 50 students in class (OR=2.61, P=.021) were significantly associated with TDI management. The teachers demonstrated inadequate knowledge about TDIs which were highly prevalent in primary schools. Male gender, having knowledge of TDI management and teaching less students were associated with increased likelihood of TDI management. There is a crucial need for the reinforcement of policies that support school safety and a supportive environment.